Impact of renal denervation on cardiac remodeling in resistant hypertension: A meta-analysis

作者全名："Xie, Linfeng; Li, Yuanzhu; Luo, Suxin; Huang, Bi"

作者地址："[Xie, Linfeng; Li, Yuanzhu; Luo, Suxin; Huang, Bi] Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiol, 1 Youyi Rd, Chongqing 400016, Peoples R China"

通信作者："Huang, B (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiol, 1 Youyi Rd, Chongqing 400016, Peoples R China."

来源：CLINICAL CARDIOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001152636600001

JCR分区：Q2

影响因子：2.4

年份：2024

卷号：47

期号：2

开始页：　

结束页：　

文献类型：Review

关键词：cardiac remodeling; renal denervation; resistant hypertension

摘要："Twelve studies involving 433 patients were included. After RDN treatment, LVMI decreased by 13.08 g/m(2) (95% confidence interval [CI]: -18.38, -7.78; p < .00001), PWTd decreased by 0.60 mm (95% CI: -0.87, -0.34; p < .00001), IVSTd decreased by 0.78 mm (95% CI: -1.06, -0.49; p < .00001), and LVEF increased by 1.80% (95% CI: 0.71, 2.90; p = .001). However, there were no statistically significant improvements in LVIDd (95% CI: -1.40, 0.24; p = .17) and diastolic function (E/A) (95% CI: -0.04, 0.14; p = .28). Drug treatment for resistant hypertension (RH) is challenging. Renal denervation (RDN) is one of the most promising treatments for RH. Although studies have shown RDN can control blood pressure, the impacts of RDN on cardiac remodeling and cardiac function are unclear. This meta-analysis evaluated the effect of RDN on cardiac structure and function in patients with RH. PubMed, Embase, and Cochrane were used to conduct a systematic search. The main inclusion criteria were studies on patients with RH who received RDN and reported the changes in echocardiographic parameters before and after RDN. Echocardiographic parameters included left ventricular mass index (LVMI), end-diastolic left ventricular internal dimension (LVIDd), left ventricular end-diastolic posterior wall thickness (PWTd), end-diastolic interventricular septum thickness (IVSTd), E/A, and left ventricular ejection fraction (LVEF). Data was analyzed using RevMan. Twelve studies involving 433 patients were included. After RDN treatment, LVMI decreased by 13.08g/m2 (95%confidence interval [CI]: -18.38, -7.78, p < .00001), PWTd decreased by 0.60mm (95% CI: -0.87, -0.34, p < 0.00001), IVSTd decreased by 0.78mm (95% CI: -1.06, -0.49, p < .00001), and LVEF increased by 1.80% (95% CI: 0.71, 2.90, p = .001). However, there were no statistically significant improvements in LVIDd (95% CI: -1.40, 0.24, p = .17) and diastolic function (E/A) (95% CI: -0.04, 0.14, p =.28). This meta-analysis finds that RDN can improve left ventricular hypertrophy and ejection fraction in patients with RH but has no significant effect on LVIDd and diastolic function. However, more studies are warranted due to the lack of a strict control group, a limited sample size, and research heterogeneity."

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